Tattoo Health Waiver
Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Country Code
-
Area Code
Phone Number
The date of my appointment is
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
I understand that this is a binding contract with Hamza Ahmad (Kaanta Lagaa) & I have been given full opportunity to ask any and all questions about my procedure. All of my questions have been answered to my satisfaction. I understand that my procedure may be permanent, and may require surgical procedure for removal. I am aware that removal may cause scarring.
I agree to this statement
I do not have any medical conditions or communicable diseases (including but not limited to diabetes, epilepsy, hemophilia, hepatitis, HIV, AIDS, tuberculosis, COVID19). I do not have a skin condition that may interfere with the proper healing of my procedure (including but not limited to acne, scarring or keloids, eczema, psoriasis, freckles, moles, or sunburn). I am not pregnant or nursing. I have informed the artist (Hamza Ahmad) and documented below of any exceptions to the above. I am not under the influence of drugs, alcohol, or any narcotic, including but not limited to prescription pharmaceuticals, & over the counter medications. I am aware that being under the influence can have an adverse effect on the procedure. I agree that the artist cannot determine if I will have an allergic reaction to any of the products used to complete my procedure. I attest that I have no known allergies, or if I do I have documented them and alerted the artist.
I agree to this statement
I am aware of the possibility of infection with my procedure. I understand that when I leave the premises of the appointment space, my procedure is only half complete. It is my responsibility to follow the aftercare procedures recommended by the artist. Hamza Ahmad makes no claim to the success or validity of the recommended aftercare procedures, they are simply guidelines. I agree to not hold the artist liable for any necessary touch-up work caused by my own negligence. I understand that skin color will have an effect on the final result of my tattoo. I agree to leave the premises of Hamza Ahmad or any other location where the artist is engaged in business promptly upon request, for any reason whatsoever, by any employee or agent of Kaanta Lagaa.
I agree to this statement
Today's Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Signature
Submit
Should be Empty: